Diverse Experiential Learning Opportunities for Diverse Patient Care

Every pivotal moment of change begins the same way. Whether it’s a scientific discovery, a societal shift or a technological breakthrough. They all have the same genesis – with someone asking the question “What if?” Because when you ask that one powerful question, you open yourself up to a world of extraordinary possibilities.

The result of asking those questions has become the bedrock of our culture. We call it Chamberlain Care®. An ethos of caring that touches every facet of Chamberlain. It’s what makes us different and what helps our students succeed.

The way nursing students are completing their practicum or clinical hours is changing. In many areas, a lack of clinical sites means fewer hands-on opportunities for students. Additionally, hospital administrators' and other health agency concerns about potential risks associated with student involvement are further limiting the availability for hands-on experience in a traditional hospital setting. Even for students who secure clinical hours at a hospital or other health agency, the experience is only as complex and well-rounded as the cases that come through the doors.

What if clinical experiences were as diverse as the patients nurses serve? As the world becomes increasingly global and technology-driven, nurses are addressing the needs of patients from diverse populations in many different healthcare settings. To help students better understand a wide range of patient needs and healthcare environments, nursing schools are incorporating more experiences outside of the classroom to complement learning and better prepare nurses for meeting consumer healthcare needs. 1

To respond to this changing environment and lack of availability of clinical training, Chamberlain has adopted a new approach – the Experiential Learning Model (ELM) – designed to optimize learning outcomes using a variety of experiences extending beyond traditional direct patient care.

“Through experiential learning students develop knowledge, skills and values from direct experience outside a traditional academic setting,” said Tricia Wagner, DNP, GNP-BC, Dean of Clinical Education at Chamberlain College of Nursing. “This approach is designed to provide a composite of experiences that best prepare students for beginning practice upon graduation.”

These opportunities provide students with a platform to collaborate, explore and reflect on what is being learned while actively participating with others in observing and using data to inform clinical decisions. By engaging students with more varied and active learning experiences, this experiential learning model helps develop engaged citizenship, foster team responsibility and highlight the importance of contributing to the broader public good – something nurses do everyday.

Through experiential learning, Chamberlain students now have access to a diverse and enriching set of experiential learning opportunities, both inside and outside the classroom, including simulated clinical experiences through the SIMCARE CENTER™ and game-based simulation as well as an online virtual learning environment.

Research shows that simulated learning experiences, which have been integrated into nursing curricula over the past 20 years, improve patient outcomes.2 Chamberlain College of Nursing developed its innovative SIMCARE CENTER™ at each of its campuses so students can hone their nursing skills in a safe, simulated clinical learning environment.

For example, what if nursing students could participate in simulated births before delivering their first baby? Patient simulators react much like an actual patient would – they have vital signs, voice discomfort and can blink, sweat and bleed. Students are challenged to react in real time to healthcare situational scenarios, including childbirth, seizures and cardiac arrest.

From privacy curtain areas to scrub sinks to hospital beds, SIMCARE CENTER facilities replicate hospital and clinical settings. The nursing skills labs feature high-tech training equipment – including patient monitoring equipment, a birthing simulator and physical assessment exam tables. As part of our commitment to academic excellence, the SIMCARE CENTER is also supported by a resource center that helps with the development of complex skills like medication calculation.

“Working with students means you have to be prepared for anything, which I love,” says Tracy Heberlig, MSN, RN, SIMCARE CENTER Manager at Chamberlain College of Nursing’s Charlotte campus. “In the SIMCARE CENTER, our students have a safe place to learn. We know they’re going to make mistakes, but we want to help them learn from those mistakes. We call that ‘falling forward’.”

In one new SIMCARE CENTER scenario, Heberlig and Chamberlain faculty enhance students’ pathophysiology course experience, where they learn about diseases of the body in the simulation lab. Staff use the SIMCARE equipment to simulate abnormal heart or lung sounds, so students can assess and respond in real time and more easily retain the information.

“Making learning active helps students not just memorize but understand their clinical education,” says Heberlig. “This is one of the things I love about what we can do in the SIMCARE CENTER lab.”

Breakdowns in communication in the healthcare setting can adversely impact patient outcomes, so Heberlig and her team emphasize the importance of communicating in the SIMCARE CENTER in addition to learning nursing skills. The lab’s collaborative environment helps students communicate with faculty, their fellow students and the patient in both clinical and simulation lab experiences.

Through interactive debriefing sessions, the SIMCARE CENTER faculty help students evaluate their experiences. In these sessions, they discuss what worked and what didn’t and address students’ feelings in the process, which encourages improvement of skills and breeds confidence.

“We want our students to reflect positively on their SIMCARE experiences and become extraordinary nurses,” she says. “By teaching future nurses how to collaborate as a team to provide safe and complete person-centered care, we are transforming healthcare in our own communities and beyond.”

In its landmark “The Future of Nursing: Focus on Education” report, the Institute of Medicine (IOM) committee recommended updating nursing curricula to educate students in new ways that mirror improvements in science and technology.3 Traditional methods of nursing education are inconsistent in preparing students with critical decision-making skills integral to improving patient care in the evolving, complex healthcare setting, argued the editors. Instead, educators frequently focus on student memorization of acute nursing terms and concepts.

Research from Brigham Young University reinforces that sentiment and confirms widely supported modern education theory that the key to improving learning outcomes is to involve students actively in the learning process.4 What if students had the opportunity to calculate more than 1,500 medicine doses before ever administering one? This is a possibility at Chamberlain College of Nursing.

“Chamberlain has been at the forefront of exploring and developing ways to apply these concepts to nursing education in order to improve student engagement and outcomes by providing a unique educational opportunity to foster our students’ success,” says Shelley A. Johnson, EdD, RN-BC, NE-BC, CNE, Dean of Curriculum and Instruction for Chamberlain’s pre-licensure undergraduate program. “Students who are encouraged to bring a critical lens to their work ultimately impart that care to their patients.”

Game-based simulation is one platform that allows students to engage directly with course material to help strengthen their foundational knowledge and prepare them to meet increasingly complex healthcare needs.

Currently, two games are integrated into the pre-licensure Bachelor of Science in Nursing (BSN) curriculum at Chamberlain – Conquering Calculations and PharmaCollegē.

Conquering Calculations assists students with the comprehension of basic calculation for safe administration of medication, and uses dimensional analysis to assist students in developing a consistent method for calculating any medication dosage. Similar to many educational games, Conquering Calculations allows students to learn and practice in a safe environment. Basic principles of drug administration and vital sign assessment are integrated in order to help students develop safe practices.

The second game, PharmaCollegē, emphasizes the nursing process across the basic principles of pharmacology and assists students in developing a greater understanding of the difference between a side effect and an adverse reaction, understanding proper procedures for safe medication administration, evaluating vital sign assessments, both before and after medication administration, and reviewing standard patient education for medications. The game creates a simulated learning environment in which students will experience the process of giving and learning about medications.

The PharmaCollegē game has been integrated into the pharmacology course, where students are introduced to a comprehensive approach to the clinical aspects of drug therapy. The emphasis is on the nursing process across the life span and basic principles of pharmacology, giving an extensive overview of drug classifications, prototype drugs, mechanisms of action and therapeutic uses.

“When students are motivated they are more apt to achieve goals, which is why the gamification of learning objectives can be so successful,” says Sharon Carol Moritz, MSN-L, RN, Curriculum Technology Manager at Chamberlain. “The competition created through educational games generates social interactions among classmates, creating a sense of community while helping master the skills needed to be an extraordinary nurse.”

People are more connected now more than ever, thanks to the globalization of technology, international travel, commerce and industry. But this interconnectedness also means health concerns, which were once limited to a community, can have a global impact. The Zika virus, the outbreak recently declared a global emergency by the World Health Organization (WHO), is the most recent example of a foreign health issue that quickly raised concern within our borders.5 What if student nurses could treat an outbreak before anyone was infected?

Nurses are using the technology that connects us to prepare for this new reality. Through virtual simulation education, they are learning to care for diverse populations and have practiced global health scenarios, including epidemics, rare illnesses and other infectious diseases.

“Globalization has changed our approach to healthcare. Viral diseases can spread rapidly, so we have to be ready,” says Dee McGonigle, PhD, RN, CNE, FAAN, ANEF, Director, Virtual Learning Enviroment (VLE) and Professor in Chamberlain College of Nursing’s Master of Science in Nursing (MSN) degree program. “Virtual learning environments can provide valuable, interactive education on best practices for patient safety and disease containment in real-time scenarios that mimic real life.”

Like the Zika virus, the Ebola crisis was a wake-up call that proved how quickly disease can spread and how important it is to be prepared. Seemingly overnight, healthcare professionals and students nationwide were tasked with developing expertise on a disease that was previously of little concern to U.S. citizens.

Chamberlain alumna Kellany Cadogan- Noland, MSN, BSN, RN, now a Clinical Learning Lab Specialist at Chamberlain, utilized Second Life®, a virtual learning environment, for her MSN Informatics Specialty Track nursing project. Second Life is a 3D, virtual world where users are known as residents, and students choose avatars as graphical representations of themselves.

Within Second Life, Cadogan-Noland created a Virtual Ebola Treatment Center (VETC) to test potential responses to an Ebola outbreak in the United States. She collaborated with mentors around the country to determine which infrastructures and clinical processes – such as clinical dressing locations for hospital staff – were most effective at disease containment. Within weeks of completion of the project, the West African outbreak had spread to the United States.6 Cadogan-Noland and her team adjusted their VETC strategy to implement and test containment plans as they were announced by the WHO.

“I benefited more from Second Life than I would have through an on-site project, because we could adapt the virtual environment to our learning needs so quickly,” Cadogan-Noland says. “I was able to quickly test scenarios through simulations. We couldn’t have accomplished this within such a short time frame in a brick and mortar facility.”

Chamberlain faculty and students can easily adapt their model of virtual simulation education to address other emerging global health issues, giving nurses like Cadogan-Noland an extraordinary window to the rest of the world. Dr. McGonigle and other Chamberlain leaders behind the VETC are planning more interprofessional collaboration in the future to explore new innovative applications of the virtual learning experience for their students.

Through experiential learning, a diverse and enriching set of learning opportunities lives both inside and outside the classroom. The use of simulated clinical experiences through the SIMCARE CENTER™, game-based simulation and an online virtual learning environment pushes education further than ever before, advancing nursing education and equipping nurses with a set of skills needed for improved healthcare outcomes.